Is a Firm Mattress Better for Your Back? What Science Says

Are firm mattresses better for your back?

• Firmer mattresses are not necessarily better for you and could cause discomfort depending on sleep position, body weight, and personal preferences.
• The best mattress for your back is one that promotes spinal alignment, provides full-body support, and offers sufficient sinkage for pressure relief.

Part of choosing a mattress means figuring out what firmness level you need. If you have back pain, you may wonder: Is a firm mattress better for your back? Firm mattresses may be better for some individuals but not others. And while hard mattresses may offer a sturdy surface to support your spine, too little sinkage can increase pressure and discomfort.

A review of scientific articles found that medium-firm mattresses are most often associated with improved comfort and better sleep quality among people with back pain.¹ Of course, exceptions exist, including when choosing between a medium or firm mattress for back pain. Your sleeping position and personal preferences play a critical role when deciding which mattress is right for you.

If you’re in search of a mattress that supports your back, look for one that helps maintain spinal alignment, offers contoured pressure point relief, and responds to movement to provide a comfortable, supportive sleep experience.

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Keep reading to learn what kinds of mattresses are best for back pain and reducing discomfort in bed. Keep in mind that if pain persists, it’s best to consult a healthcare professional. 

What Type of Mattress Is Best for Back Pain?

There is no universal mattress that is best for back pain. A variety of mattresses can provide spinal support and pressure relief, including hybrid, foam, or innerspring designs. The best option for you depends on your sleep position and unique preferences, as these factors influence the firmness level that will best support your body’s alignment. 

Mattress Type

The type of mattress that works best for you depends on your needs and the quality of its construction. If you know you prefer soft, medium, or firm mattresses, you can begin narrowing your options. 

Different types of mattresses are often available in a range of firmness levels, but firmness isn’t the only factor to consider. Additional design features like zoned support, responsiveness, and pressure relief can significantly affect comfort and back support. Some of the most popular mattress options include:

• Memory foam: Memory foam mattresses tend to be softer. While sinking deeply into memory foam may contribute to discomfort or back pain, this type of mattress may appeal to sleepers who want a cradling feel that cushions their pressure points.
• Hybrid: Hybrid mattresses like the Restore® Hybrid Mattress combine a stable internal structure with comfort layers to provide ample support and pressure relief with a medium-to-firm feel. This makes them a suitable choice for a wide range of sleepers.
• Innerspring: Higher quality innerspring mattresses tend to offer firm support that promotes spinal alignment. They often provide less pressure relief for other areas, such as the hips and shoulders, especially in lower-quality models.

Mattress Firmness

Mattresses are usually advertised as being soft, medium-soft, medium-firm, or firm. That said, a mattress firmness scale isn’t always the most accurate way to judge, because firmness ratings can vary between manufacturers. Depending on your weight, sleep position, location of any pain, and personal preferences, a medium, firm, or soft mattress may be better for your back.

Here’s a quick overview of the main mattress firmness levels:

• Soft: A cradling feel with more sinkage can relieve pressure points but may reduce spinal support.
• Medium-soft: More responsive than soft beds, a medium-soft mattress pushes back to support spinal posture with plenty of give to cradle joints.
• Medium-firm: Firm enough to support your back with more cushion than firmer options, medium-firm beds may be comfortable for a range of sleepers.
• Firm: Minimal sinkage may keep your back aligned but could cause discomfort in the hips and lower back, especially if you experience sciatica discomfort while sleeping.

Remember, these mattress firmness levels may feel different depending on your sleep position, weight, and specific body needs. Some people may prefer a medium or firm mattress for back pain, while others find a soft mattress provides the relief they need. Ultimately, you should test out different mattresses in store to determine what feels most comfortable and supportive.

How To Choose the Best Mattress for Back Support

The best bed for an achy back may be different for each person. It’s a good idea to consider your sleep position, body weight, pressure relief needs, and personal preferences to determine the ideal firmness level for your mattress. 

Remember, these guidelines are starting points, not absolute rules. Your personal comfort and support needs should guide the final decision. 

1. Consider Your Sleep Position

Your preferred sleep position plays a major role in which mattress firmness will feel comfortable and supportive. The best mattress for back support also depends on your weight and personal comfort preferences, sleep style is a good starting point:

• Side sleepers: A medium-firm bed can be the best mattress for back support, and side sleepers benefit from the combination of push-back and cushioning. Some side sleepers may prefer a medium-soft mattress, which reduces pressure on the hips and shoulders.
• Back sleepers: Medium to firm mattresses offer enough resistance to keep your spine aligned while distributing body weight evenly to reduce strain on the lower back.
• Stomach sleepers: For stomach sleepers, a medium-firm to firm bed which reduces lower back strain by preventing the stomach from sinking too deeply into the mattress.
• Combination sleepers: Sleepers who toss and turn can opt for a responsive medium-firm mattress for a blend of push-back and pressure-relieving sinkage.

2. Account for Your Body Weight

Mattresses feel different depending on your weight. A firm mattress may feel softer and more adaptive and supportive to a heavier individual because it offers greater push-back to promote spinal support. For a person who weighs less, a firm mattress may not cradle their pressure points effectively, resulting in stiffness and discomfort.²

Even weight distribution promotes back support and pressure relief, regardless of your size. Once you’ve determined which firmness level feels most comfortable for you, keep mattress weight limits in mind to reduce the risk of premature sagging and maintain consistent support over time.

3. Prioritize Pressure Relief

Choosing a mattress that adapts to your body and cushions your pressure points can provide meaningful relief to prevent or alleviate back pain. Pressure relief helps ensure even weight distribution and reduces muscle fatigue and chronic tightness, particularly in the hips, shoulders, and lumbar region.³

Firm mattresses offer minimal to no sinkage, which can limit how much pressure relief you get when you lie down. While traditional guidance has recommended firm mattresses for back pain, many sleepers find these beds stiff and uncomfortable. On the other hand, too much sinkage can put more pressure on your joints, so it’s important to find a balance of stability and pressure relief that works for you.

4. Invest in Supportive Materials

High-quality mattresses will not only last longer thanks to their use of more durable materials, but they may also provide the best combination of support and comfort. This is especially true of mattresses with design elements like zoned support for targeted pressure relief, motion isolation, and responsive support that help keep you from feeling “stuck” in the mattress. 

With distinct layers designed to evenly distribute body weight, promote spinal support, and cradle pressure points as you move, mattresses made with supportive, durable materials (like the RestorePremier® Hybrid Mattress) may be the best choice for sleepers in need of a comfortable, supportive solution.

In fact, according to a 2025 sleep study by SleepScore Labs, participants reported a 63% average reduction in the impact of pain on sleep when sleeping on a Restore Collection mattress.⁴ These improvements indicate that thoughtfully engineered design and construction can meaningfully influence sleep quality by minimizing nighttime discomfort.

5. Trust Your Personal Preferences

You’ll spend every night lying in your new bed, so it’s important to consider your comfort preferences over generalized recommendations—especially if you plan to buy your mattress online. For example, even if an extra-firm bed seems like the best option to support your back, a hard mattress that leaves your hips and shoulders sore or keeps you awake won’t give you the quality rest you need.

If you aren’t sure where to start, medium-firm mattresses are some of the most popular options with a balance between firm and soft. Trust your body, and try a range of firmness levels to determine what feels best. 

Remember, don’t worry as much about whether a specific firmness is recommended as how a particular mattress feels comfortable for you. Don’t just focus on first-night comfort, either. It can take your body three to six weeks to adapt to a new mattress and for the mattress to get broken in. Give yourself time to adjust to the new level of support and pressure relief before determining if the mattress meets your needs.

Can a Mattress Cause Back Pain? 5 Tips to Prevent and Relieve Discomfort

While your bed should be a peaceful place to rest your head, an unsupportive, worn, or uncomfortable mattress can also directly contribute to back pain, sore joints, or aching muscles. Whether a new mattress is contributing to back pain or you’ve been sleeping on the same mattress for many years, there are several options you can try to get relief.

1. Place a Pillow Under Your Knees

One of the easiest ways to relieve back discomfort is to try sleeping with a pillow between your legs for side sleepers or under your knees for back sleepers to keep your hips and lower spine aligned.

This position can relieve pressure on the lower back and allow you to sleep more comfortably. Opt for a small or travel-sized pillow like the compact Purple Harmony Anywhere™ Pillow to provide targeted elevation and support.

2. Change Your Sleep Position

Some sleep positions are better than others for preventing and relieving back discomfort. Learning how to sleep on your back can help promote healthy spinal alignment and reduce discomfort caused by stomach sleeping or excessive pressure on the hips when sleeping on your side. Switching your sleep position may take practice, but it can significantly affect overall comfort and spinal support.

3. Make Your Mattress Softer or Firmer

If your current mattress doesn’t feel as soft or firm as you’d like, you can adjust the feel without immediately investing in a new bed. For example, if you want to make your mattress firmer or softer, you can add a mattress topper that alters the surface feel. These methods do not work for Purple mattresses, and attempting them may void your warranty.

Other methods include:

• Trying a bunkie board
• Replacing the box spring or foundation
• Rotating your mattress

4. Try an Adjustable Base

An adjustable base won’t change how firm your mattress feels, but it can help relieve pressure on different parts of your body. Elevating your feet can reduce strain on your lower back, and zero-gravity settings can support the natural curvature of your spine to promote healthier alignment. 

Using an adjustable base can also help relieve symptoms of other sleep-related issues, such as sleep apnea, acid reflux, and chronic pain.⁵ Consult a medical professional about how an adjustable base could help with these conditions. Purple adjustable bases allow for personalized comfort, with options that offer head and foot elevation as well as zero-gravity settings.

5. Choose a New Mattress

If other adjustments don’t help your back pain, consider buying a new mattress altogether. The best mattress for back pain depends on several factors, but you should ultimately choose a bed that:

• Distributes your weight evenly
• Supports your spine in your preferred sleep position
• Relieves pressure in sensitive areas 

Visiting a showroom to test mattresses in person can help you decide which firmness level feels best for you. 

Remember that you may need to break in your new mattress before it feels comfortable and offers relief. Look into manufacturer sleep trials and warranties to ensure that you can try out a mattress before fully committing to it.

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Firmness vs. Support for Back Pain

The choice between a firm or soft mattress for back pain isn’t always as straightforward as it might seem. A mattress can feel softer but still support alignment, such as mattresses with Purple’s GelFlex Grid®, or it could be firm but unsupportive, like a cheap innerspring mattress. 

Because of this, you shouldn’t just focus on mattress firmness. Evaluate support, pressure relief, and overall quality.

Remember, firmness generally describes how much you sink into the mattress, while support focuses on how well it keeps your spine aligned during sleep. Firmness levels can vary by preference and sleep position. A mattress should consistently promote spinal alignment and relieve pressure points.

Firm vs. Medium-Firm Mattresses for Back Pain

Is a medium-firm mattress good for back pain, or are firm beds better for your back? In the past, doctors often recommended sleeping on a firm mattress to promote spinal alignment, but more recent research indicates that a firm mattress can in some cases make back pain and sleep quality worse.⁶ 

A mattress that is too firm can worsen back pain because:

• Insufficient contouring keeps the body from sinking to accommodate the natural curvature of the spine
• Pressure may concentrate at the hips and shoulders
• Insufficient pressure relief can contribute to overnight muscle tension²

Current research indicates that medium-firm mattresses are generally the best option for improving comfort and reducing back pain thanks to their balance of support and pressure relief.¹

Sleep Well With a Good Mattress for Back Support

So, is a firm mattress better for your back? The truth is that there is not a universal mattress that is best for spinal support because every individual has unique needs. 

A medium-firm mattress works well as a starting point, but you should refine your selection based on your sleep position, body weight, and comfort preferences. Rather than focusing on firmness level alone, choose a mattress that distributes your weight evenly, supports the curve of your spine, and alleviates pressure.

If your back is stiff and sore from sleeping on a bad mattress, it may be time to invest in a bed that improves comfort and supports posture. Try out the Purple Mattress® to experience the revolutionary, instantly adaptive GelFlex Grid® for your most comfortable sleep yet.

Instantly Adapts To Your Body

The GelFlex® Grid responds to your movement, cradling pressure points and supporting your back for maximum comfort.

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